CBCT图像引导下SBRT治疗肺部原发灶或转移灶的初步研究

[目的]评价CBCT图像引导技术下SBRT治疗原发性肺癌或肺转移瘤的安全性和初步疗效。[方法]2012年8月至2013年10月共9例患者在浙江省肿瘤医院接受CBCT图像引导下SBRT胸部放疗，中位年龄68岁。每次照射前行KV级CBCT扫描并在线配准。每次照射剂量5．0～12．5Gv．每日1次，中位照射次数8次（4～10次）；BED76．8～112．5Gy（中位96Gy）。[结果]9例患者均安全完成放疗，总有效率为77．8％。其中CR1例（11．1％），PR6例（66．7％），SD2例（22．2％），无PD患者，未出现3度以上放射性毒副反应。中位随访8．8个月（1．3～14．6个月），1年局部控制率及总生存率分别为88．9％和100％。[结论]CBCT图像引导下SBRT治疗早期肺癌或肺转移瘤近期疗效明确．毒副反应低．远期疗效有待进一步随访。

Stereotactic Body Radiation Therapy Guided by Cone Beam Computed Tomography for Primary or Metastatic Lung Malignancy

[Purposel To investigate the clinical efficacy and toxicity of image-guided stereotactic body radiation therapy （SBRT） with daily online cone beam computed tomography（CBCT） for primary or metastatic lung malignancy. [ Methods ] Nine patients with primary or metastatic lung cancer who received CBCT-guided SBRT from Aug 2012 to Oct 2013 in Zhejiang Cancer Hospital were retro- spectively analyzed.The median age was 68 years. Daily online cone beam computed tomography was used before each treatment. SBRT was prescribed that fractional dose was 5.0-12.5Gy daily with median of eight fractions （4-10）. The biological equivalent dose （BED） ranged from 76.8 to 112.5Gy （median 96Gy）. [Results] Nine patients completed the planned radiation. The overall response rate was 77.8%（7/9）. One（11.1%） patient achieved CR ; 6（66.7%）, PR ; 2（22.2%）, SD ; none PD. No grade 3 or up toxicities was found. The median follow-up was 8.8 months （1.3-14.6 months） , the 1-year local control rate and overall survival were 88.9% and 100% ,respectively. [Conclusion] SBRT with daily online CBCT for primary or metastatic lung cancer achieves excellent short-term response with low toxicity ,long-term response needs further follow-up.